Organization · Type 2 NPI

Cherry Lane Family Clinic, PA

Family Medicine Physician · Meridian, ID

NPI number 1962554063 Active

About NPI 1962554063

Cherry Lane Family Clinic, PA's National Provider Identifier is 1962554063, issued on Jan 17, 2007. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Meridian, ID. The record was last updated on Sep 14, 2010.